intro

Question 1

• Approximately —-% of adults aged 20 to 64 have no teeth and almost ___% of seniors (above the age of 65) have no remaining teeth.

Answer 1

• Approximately 5% of adults aged 20 to 64 have no teeth and almost 30% of seniors (above the age of 65) have no remaining teeth.

Question 2

The leading causes for teeth loss are:

Answer 2

The leading causes for teeth loss are caries and periodontal disease.

Question 3

• Approximately ____% of US adults aged 20-64 had dental caries in 2011-2012, ____% of
  which suffered from untreated dental caries.

Answer 3

• Approximately 91% of US adults aged 20-64 had dental caries in 2011-2012, 26% of
  which suffered from untreated dental caries.

Question 4

• Periodontal disease affects —-% of the population between 35-44 years of age and —–% of people over 65 years of age.

Answer 4

• Periodontal disease affects 75% of the population between 35-44
  years of age and 95% of people over 65 years of age.

Question 5

• ____ million Americans are missing at least one tooth, and more than ____ million are currently edentulous, _____ of which in both arches (ACP).

Answer 5

• 120 million Americans are missing at least one tooth, and more than 36
  million are currently edentulous, 2/3 of which in both arches (ACP).

Question 6

success % of implants

Answer 6

95

Question 7

CD % function restored

Answer 7

30

Question 8

RPD %function restored

Answer 8

60

Question 9

Fixed Dental Prostheses (Crowns
and Bridges) % function restored

Answer 9

100% of lost function restored
* Can be tooth or implant supported

Question 10

Dental Implant

Answer 10

“A prosthetic device or alloplastic material implanted into the oral tissues beneath the mucosal and/or periosteal layer, and/or within the bone to provide retention and support for a fixed or removable dental prosthesis.”

Question 11

Implant Categories

Answer 11

• Eposteal: on/around the bone
• Transosteal: through the bone
• Endosteal: in the bone
• ■EPOSTEAL - Subperiosteal
  ■TRANSOSTEAL-Transmandibular
  ■ENDOSTEAL - Blade and Root Form

Question 12

subperiosteal implants

metal? supported by? cost? survival? indication? bone?

Answer 12

■Vitallium metal
■Denture is implant supported /expensive
■Survival rate 85% Ten years (Harvard Consensus)
■Indicated for atrophic edentulous mandible.
■Bone resorption leads to mobility infection and loss

Question 13

transosteal implants
metal?
success?
indicated?
supported by?
requires?

Answer 13

■Titanium metal
■91% Success rate at fifteen years (excellent)
■Only indicated for the edentulous mandible
■Denture is tissue supported
Requires one surgery usually in the hospital.
External incision / approach.
Excellent for the atrophic mandible where root form implants would weaken the jaw.
Complex surgical procedure therefore not widely used.
Restricted to the anterior mandible. (post=IA nn)

Question 14

transmandibular implants
■% success rate
■used for?
■indication?
■metal?
■Reversible?

Answer 14

■97% success rate
■used for Implant supported denture
■Used in severe atrophic mandibles <10mm
■Gold Alloy, not titanium
■Reversible – can be removed due to design of screws and degree of integration, but not easy process

Question 15

endosteal implant types

Answer 15

Question 16

blade implants
metal?
best for?
% survival?
when ceased?

Answer 16

■Titanium metal
■One stage/best for partially edentulous mandibles
■75% five year survival
■Most widely used until 1980

Question 17

blade implants failures/drawbacks

Answer 17

■Early failures due to heat at preparation and immediate loading
■Drawbacks: Difficult to prepare a precision slot and if it fails, a large section of bone is involved

Question 18

Answer 18

blade implant

Question 19

root form implants
success?
indicated?
uses?

Answer 19

■Success rate greater than 90%
■Indicated for partially and fully edentulous cases/any area of the mouth (versatility)
■Multiple uses: overdenture, hybrid, crown and
bridge, ortho anchorage…

Question 20

root form implants
■ metal(s)?
■ stage approach?
■In office?
■types?
■implant surface types?

Answer 20

■Titanium or an alloy of titanium-aluminum-vanadium metal(s)
■1 or 2 stage approach
■In office procedure
■Screws/Cylinders
■Machined or rough (to increase surface area for integration)

Question 21

super implants

Answer 21

zygomatic and pterygoid
no need for bone grafting

Question 22

osseointegration

Answer 22

Brånemark introduced the term osseointegration and defined it
as “a direct structural and functional connection between
ordered, living bone and the surface of a load-carrying implant.”

Question 23

why use Ti?

Answer 23

■Not recognized as a foreign object by the body
■Less host rejection than other metals/alloys
■Medicine also recognized utilization in joint replacements
and heart valves

Question 24

impants vs teeth

Answer 24

• Important distinction from
  natural dentition
• Implants are not teeth and
  there is extensive evidence
  that they behave differently

Question 25

implants and dx

Answer 25

Not susceptible to the same disease processes that affect our dentate patients. Teeth: *Caries *Periodontal disease Implants: *Peri-implantitis (bone) *Peri-mucositis (soft-tissue)

Question 26

possible implant designs

Answer 26

mainly use two piece due to tx felibility

Question 27

tissue vs bone level implants | most today are?

Answer 27

tissue level: screw portion in bone and small collar above bone bone level: only present in bone, none present in soft tissue most today are bone level, more flexibility

Question 28

implant platforms

Answer 28

internal vs external hexes location male and female parts differ

Question 29

single implant survival rate

Answer 29

94-98

Question 30

failure % relative to placement of restoration (before vs after placement)

Answer 30

~55-60% of failures occur prior to the placement of the restoration ~40-45% occur after the restoration placement

Question 31

failure % after placement | time frames

Answer 31

* 57% of the failures occurred in 1st year * 34% of the failures occurred in the 2nd year * 9% of the failures occurred in the 3rd year * 0% after?

Question 32

bone loss with implants

Answer 32

* Average of 1mm during 1st year * Average of 0.1 mm each year after

Question 33

soft tissues with implants | mostly occurs when?

Answer 33

1mm of soft-tissue recession can generally be expected during the first year. Most of this occurs within the first three months following abutment connection surgery.